The panic attack-posttraumatic stress disorder model: applicability to orthostatic panic among Cambodian refugees

Cogn Behav Ther. 2008;37(2):101-16. doi: 10.1080/16506070801969062.

Abstract

This article examines the ability of the panic attack-posttraumatic stress disorder (PTSD) model to predict how panic attacks are generated and how panic attacks worsen PTSD. The article does so by determining the validity of the panic attack-PTSD model in respect to one type of panic attack among traumatized Cambodian refugees: orthostatic panic (OP) attacks (i.e. panic attacks generated by moving from lying or sitting to standing). Among Cambodian refugees attending a psychiatric clinic, the authors conducted two studies to explore the validity of the panic attack-PTSD model as applied to OP patients (i.e. patients with at least one episode of OP in the previous month). In Study 1, the panic attack-PTSD model accurately indicated how OP is seemingly generated: among OP patients (N = 58), orthostasis-associated flashbacks and catastrophic cognitions predicted OP severity beyond a measure of anxious-depressive distress (Symptom Checklist-90-R subscales), and OP severity significantly mediated the effect of anxious-depressive distress on Clinician-Administered PTSD Scale severity. In Study 2, as predicted by the panic attack-PTSD model, OP had a mediational role in respect to the effect of treatment on PTSD severity: among Cambodian refugees with PTSD and comorbid OP who participated in a cognitive behavioural therapy study (N = 56), improvement in PTSD severity was partially mediated by improvement in OP severity.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Asian / psychology*
  • Cambodia / ethnology
  • Cognitive Behavioral Therapy / methods
  • Comorbidity
  • Dizziness / ethnology
  • Dizziness / psychology*
  • Dizziness / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Psychological
  • Panic Disorder / ethnology
  • Panic Disorder / psychology*
  • Panic Disorder / therapy
  • Prevalence
  • Refugees / psychology*
  • Regression Analysis
  • Reproducibility of Results
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / ethnology
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / therapy
  • United States